What is stress urinary incontinence?
It is a condition that occurs when there is leakage of urine from the bladder during physical activity or exertion. Stress urinary incontinence is the most common type of urinary incontinence in women.
Why do I have stress urinary incontinence?
Stress incontinence occurs when the muscles that control the flow of urine do not work properly.
The bladder and urethra are supported by the pelvic floor muscles. Urine passes from the bladder through the urethra to the outside.
The sphincter is a muscle located around the opening of the bladder. This is compressed to prevent urine from escaping through the urethra.
When any of these muscle groups weakens, urine can pass when pressure is exerted on the bladder.
What tests or complementary studies should be done?
Your gynecologist will perform:
- A physical examination, which may reveal that the bladder or urethra is coming out into the vagina.
- Cystoscopy to visualize the inner part of the bladder.
- Ultrasound of the urinary tree with post-voiding residual measurement: to determine the amount of urine remaining after urination.
- Urinalysis to check for urinary tract infection
- Urinary stress test: you are asked to stand with your bladder full and then cough.
- Urodynamic studies to measure the pressure and flow of urine.
What is the treatment of stress urinary incontinence?
The treatment depends on the way in which the symptoms affect your daily life. We may ask you to record the number of times you urinate during the day and night and the frequency of urine leaks.
There are four types of treatment for stress urinary incontinence depending on its severity:
- Changes in habits
- Pelvic floor muscles training
- Laser Incontilase®
Changes in habits
- Drink less liquid (if you drink more than 1.5L per day).
- Avoid jumping or running.
- Consume fiber to avoid constipation since it can worsen urinary incontinence.
- Stop smoking. This can reduce cough and irritation of the bladder. Smoking also increases the risk of bladder cancer.
- Avoid alcohol and drinks with caffeine such as coffee. They can make you want to urinate.
- Lower the extra weight.
- Avoid foods and drinks that can cause bladder irritation. These include spicy foods, carbonated beverages, citrus fruits, coffee and tea.
- If you have diabetes, keep your blood sugar under control.
Training the pelvic floor muscles:
There are different ways to strengthen the pelvic floor muscles.
- This method can help you learn to identify and control the pelvic floor muscles. Generally, they are performed by midwives or physiotherapists specialized in pelvic floor.
- Kegel exercises can help keep the muscles around the urethra strengthened and functioning well. This can help prevent leakage of urine.
It is advised in patients with severe urinary incontinence.
- The tension-free vaginal tape holds the urethra. It is a simple surgery and with very good postoperative recovery. It can be done with general or locoregional anesthesia.
Source: Medline Plus: National Library of Medicine of the USA
- Lifting heavy objects
- Pregnancy – vaginal delivery
- Injury in the urethral area
- Some medications
- Surgery of the pelvic area
- If you have pelvic prolapse. This happens when the bladder, urethra or rectum slide into the vagina. A childbirth can cause nerve or tissue damage in the pelvic area. This can lead to pelvic prolapse occurring months or years after delivery.
The main symptom of stress urinary incontinence is the escape of urine after the above-mentioned situations